What about fertility staff emotions? An explorative analysis of healthcare professionals’ subjective perspective

Abstract

Infertility-related psychological research is traditionally oriented to analyze the wellbeing of couples undergoing Assisted Reproductive Technologies (ART), than to study the job-related effects on the healthcare fertility staff. This piece of research aims at understanding the subjective perspective of the fertility professionals and contribute to identify their emotional dynamics in their work environment. An in-depth explorative research study was conducted on 12 healthcare professionals of an Italian ART hospital clinic. Structured interviews with open-ended questions were administered to explore their deep feelings about their professional experience. Emotional text analysis was then conducted to analyze the textual corpus of their narratives to grasp their affective symbolizations. Statistical multidimensional techniques were used to detect some thematic domains (cluster analysis) and latent factors organizing the contraposition between them (multiple correspondence analysis). Five thematic domains were detected which refer to different emotional dimensions, as follows: performance anxiety (Cluster 1), ambivalence between omnipotence and powerlessness (Cluster 2), care burden (Cluster 3), feeling of duty (Cluster 4), and sense of interdependence (Cluster 5). Then, four latent factors were identified dealing with the laborious attempt to remedy, the realistic sense of limitation, the incumbent feeling of pressure and the restorative sense of justice, respectively. The results are discussed based on the existing literature and some useful recommendations for staff education, training and clinical supervision are provided accordingly.

The need to restore generative identity in women undergoing assisted reproductive technology: Development and psychometric validation of the fertility reparation inventory

“…Indeed, each new ART cycle follows the unprocessed mourning of a loss with persistence to repeat (Mann, 2014). This appears in line with previous qualitative research on women undergoing ART, showing the tendency to bear all the efforts and sufferings it takes to achieve their motherhood dream (Fedele et al, 2020). A diagnosis of infertility often triggers a strong sense of personal deficiency due to failing “essentially to do what you're put on earth to do” (Schofield, 2015, pp.…”

“…Besides, only expiatory reparation was positively associated with perceived infertility-related stress, as well as with anxiety and depression measures with medium to high effect sizes. As regard with this, the overwhelming experience of guilt (proper of expiatory reparation) in women undergoing ART has been reported in past research, highlighting feelings of grief, self-deprecation, stigma, shame, and threat due to the unmet parenthood expectations and perceived social pressure to procreate (Fedele et al, 2020;Yao et al, 2018). Such guilt feelings represent a significant source of infertility distress that often leads to increased anxiety and depression in pathways of medically assisted reproduction and is further enhanced when faced with treatment failures (Pozza et al, 2019).…”

“…As well, the miraculous possibilities to generate life beyond nature offered by ART may make women less prone to accept the infertility-related limitations and renounce the dream of biological motherhood (Castellano et al, 2011;Fedele et al, 2020). However, even when faced with the success of ART treatment, the representation of one's generativity can remain compromised because ART does not succeed to definitively heal the narcissistic wound of infertility, further confirming not having been able to conceive a child alone (Agostini et al, 2009).…”

“…In this regard, previous research has highlighted the presence of such ambivalent feelings also in the fertility staff as countertransference responses to the process of idealization and devaluation enacted by patients (Castellano et al, 2011;Fedele et al, 2020). On the one hand, there is a sense of grandiosity in pursuing the ambitious mission of realizing the couple's procreative dream beyond the limits of nature and rehabilitating patients' image, according to a restorative sense of justice (Castellano et al, 2011;Fedele et al, 2020). Indeed, also care professionals may resort to manic reparation to confirm that they have sufficient abilities to repair damage in others, as to defend themselves against their fear to failure (Caputo et al, 2020b;Caputo, 2020;Roberts, 1994).…”

“…However, the highly technical nature of the ART professionals' work may engender the risk of depersonalizing patients looked at as childbearing machines, thus leading to potential burnout and reduced work meaningfulness over time (Fedele et al, 2020;Gupta & Richters, 2008).…”